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ADHD, Autism, Biploar, What is it? Where do I go from here?
My second child is a four year old boy. I am becoming increasingly concerned for him because of his behavior. Ever since he was born his behavior has always struck me as different. Some of the highlights include: He would cry so much for long periods of time. During car rides he would scream the entire time. I finally found something to console him--a particular Norah Jones song which upon hearing the first note (seriously) he would stop. About six months of age he began head-banging. He would hit his head on the floor repeatedly, even if it started to redden or swell. If he was being held the safest way to hold him was his back against your chest because if he became frustrated or angry he would throw himself outward. At around 18 months he would color in those little chunky notebooks for long periods of time. He began sleeping through the night shortly after turning three years old. There were times where he would have what I think were nightmares--he would all of a sudden scream and kick and thrash about in his bed.
Now more currently: Things must occur as a routine or be something he is familiar with. He becomes easily frustrated with things (standing up action figures, putting blocks together, etc.). By frustrated, I mean meltdowns. When things don't go the way he wants or he is not instantly given what he wants this triggers a meltdown. These are more than temper tantrums. I am very concerned that he will actually hurt someone or himself. For example, once on the way home he started kicking my chair, then pulling my hair, and then scooted himself down his booster chair to bring his legs up to try to kick my head while I was driving. I pulled over and was able to calm him down so that I could begin driving again but even after that he would start up again and then I would be able to verbally calm him but it would be a cycle of start up, calm down, for at least three times in 15 minutes. All this was brought about because he was not able to catch a ball during practice. I have him involved in T-ball practice with children his own age. He becomes easily distracted and will go up to the other kids and wack the bills of their caps down, throw rocks, or block everyone out and do his own thing. Even in coversations, he will get distracted, block out that it isn't happening then interrupt with something totally unrelated. He likes power rangers now and likes to stand them up in a particular order, and it has to be that particualr order. He used to like to play with chess pieces and line them up in a certain way. Sometimes he has to do certain movements or actions, he can't help himself, it is something he just has to do--like touching objects he sees or touching them a certain amount of times. Sometimes he acts as if he is not aware of others or their feelings.
His behavior is cyclic. He will go through periods of time when he is very loving, sweet, caring, and for the most part behaving like every other child his age. The he will go through times when he has maybe three to four meltdowns a day, become very defiant and often block things/people/conversations out.
I had him tested through a community outreach program that is linked with the school system. To see what a meltdown was like the examiner drizzled glue onto a desk. He flipped out and she was able to see what one was like. After completed the further testing (speech, development, psych, behavioral, etc) the only thing that came up was that he was very intelligent (they actually recommended that I have him tested to be in the gifted and talented program later this year) and had some characteristics of ADHD (they would not diagnosis him with this because they said it was out of their scope to do so). The initial referral for this testing came from his pediatrician who also noted things in his behavior--he was suggesting maybe Austism/Aspergers or ADHD. Now I read that many times children are misdiagnosed with these disorders when in fact they may be bipolar.
I would really like to hear some feedback on what others think about this. I am frustrated because if he has a behavioral issue then I would like a definite answer so that I can know what to do about it--what my next step is. I am also tired of people saying I am a bad parent because my child is just naughty. I need direction before his behavior gets worse.
Now more currently: Things must occur as a routine or be something he is familiar with. He becomes easily frustrated with things (standing up action figures, putting blocks together, etc.). By frustrated, I mean meltdowns. When things don't go the way he wants or he is not instantly given what he wants this triggers a meltdown. These are more than temper tantrums. I am very concerned that he will actually hurt someone or himself. For example, once on the way home he started kicking my chair, then pulling my hair, and then scooted himself down his booster chair to bring his legs up to try to kick my head while I was driving. I pulled over and was able to calm him down so that I could begin driving again but even after that he would start up again and then I would be able to verbally calm him but it would be a cycle of start up, calm down, for at least three times in 15 minutes. All this was brought about because he was not able to catch a ball during practice. I have him involved in T-ball practice with children his own age. He becomes easily distracted and will go up to the other kids and wack the bills of their caps down, throw rocks, or block everyone out and do his own thing. Even in coversations, he will get distracted, block out that it isn't happening then interrupt with something totally unrelated. He likes power rangers now and likes to stand them up in a particular order, and it has to be that particualr order. He used to like to play with chess pieces and line them up in a certain way. Sometimes he has to do certain movements or actions, he can't help himself, it is something he just has to do--like touching objects he sees or touching them a certain amount of times. Sometimes he acts as if he is not aware of others or their feelings.
His behavior is cyclic. He will go through periods of time when he is very loving, sweet, caring, and for the most part behaving like every other child his age. The he will go through times when he has maybe three to four meltdowns a day, become very defiant and often block things/people/conversations out.
I had him tested through a community outreach program that is linked with the school system. To see what a meltdown was like the examiner drizzled glue onto a desk. He flipped out and she was able to see what one was like. After completed the further testing (speech, development, psych, behavioral, etc) the only thing that came up was that he was very intelligent (they actually recommended that I have him tested to be in the gifted and talented program later this year) and had some characteristics of ADHD (they would not diagnosis him with this because they said it was out of their scope to do so). The initial referral for this testing came from his pediatrician who also noted things in his behavior--he was suggesting maybe Austism/Aspergers or ADHD. Now I read that many times children are misdiagnosed with these disorders when in fact they may be bipolar.
I would really like to hear some feedback on what others think about this. I am frustrated because if he has a behavioral issue then I would like a definite answer so that I can know what to do about it--what my next step is. I am also tired of people saying I am a bad parent because my child is just naughty. I need direction before his behavior gets worse.
Wow. Thank you so much. I now have more direction and know where to go from here. I will definitely research more on this to definitely include what you have mentioned and then will go back to his pediatrician to obtain a referal for more professional testing. I really would like an answer so that I can better meet his needs as a parent. Thank you.
Are these people qualified professionals who are experienced in diagnosing autistic spectrum disorders and aspergers? Not every child spins or flaps or cannot make eye contact. That is why it is called a 'spectrum' disorder. There are many characteristics and each child only has to have enough of them. No two children will be the same.
You say the Speech Therapist said he has no problems. I would write to her and ask her to tell you what standard assessments she carried out and what his results were. She has just given you a general statement and she may not have even carried out any assessments and I suspect she definately hasn't carried out a full batch of assessments to cover all areas of speech and social interaction.
You have said in your post that he blocks out conversation and then interrupts with something totally unrelated. And you've also said that he sometimes struggles to get his speech together and say what he wants. How can that be okay? Those difficulties will make it hard for him to learn in school and he will also have problems with social interaction and play.
He also sounds like he might have (google) Sensory Integration Disorder, which can be a disorder on its own but most (if not everyone) on the autistic spectrum has sensory issues.
Excuse my ignorance, but I don't know where Guam is? But you need a developmental paediatrician with experience of autistic spectrum disorders to see him, as well as a Speech Therapist, Clinical Psychologist and Occupational Therapist. And they should ALL have experience of children with autistic spectrum disorders.
There are often posts like yours on the Autism and Aspergers forums about being told their child isn't autistic because they can ....., but it isn't as black and white as that. And professionals who don't have daily experience of meeting and diagnosing children with this disorder make a judgement on what they think they know - and often that doesn't amount to much. When you think that Einstein was suspected of being on the autistic spectrum it makes you see how vast the range of difference can be from a child who is severely autistic to one who has it to a milder degree, or one who has aspects of different disorders.
My son also copies the words and moves from TV and DVDs. This is called echolalia. Google delayed echolalia and autism for an explanation of what it is, and again remember that each person will use it to a different degree. My son also talks and is assessed as 'age appropriate', but his receptive speech (understanding what is said to him) is affected. And the fact that he is echolalic means that he can use words and phrases that sound very grown up, but I know what TV programme or film they have come from.
Also the over emotional outbursts and reactions are typical. My son goes to foil fencing classes, and as part of the warm up exercises they use a skipping rope and have to run under it and then jump over it. He could run under, but not jump over. Neither could alot of the other children and coped with that fine. He was in tears in the floor every time! But he loves the sword fighting and is quite good at it (because he loves those films and copies the moves all the time).
You say the Speech Therapist said he has no problems. I would write to her and ask her to tell you what standard assessments she carried out and what his results were. She has just given you a general statement and she may not have even carried out any assessments and I suspect she definately hasn't carried out a full batch of assessments to cover all areas of speech and social interaction.
You have said in your post that he blocks out conversation and then interrupts with something totally unrelated. And you've also said that he sometimes struggles to get his speech together and say what he wants. How can that be okay? Those difficulties will make it hard for him to learn in school and he will also have problems with social interaction and play.
He also sounds like he might have (google) Sensory Integration Disorder, which can be a disorder on its own but most (if not everyone) on the autistic spectrum has sensory issues.
Excuse my ignorance, but I don't know where Guam is? But you need a developmental paediatrician with experience of autistic spectrum disorders to see him, as well as a Speech Therapist, Clinical Psychologist and Occupational Therapist. And they should ALL have experience of children with autistic spectrum disorders.
There are often posts like yours on the Autism and Aspergers forums about being told their child isn't autistic because they can ....., but it isn't as black and white as that. And professionals who don't have daily experience of meeting and diagnosing children with this disorder make a judgement on what they think they know - and often that doesn't amount to much. When you think that Einstein was suspected of being on the autistic spectrum it makes you see how vast the range of difference can be from a child who is severely autistic to one who has it to a milder degree, or one who has aspects of different disorders.
My son also copies the words and moves from TV and DVDs. This is called echolalia. Google delayed echolalia and autism for an explanation of what it is, and again remember that each person will use it to a different degree. My son also talks and is assessed as 'age appropriate', but his receptive speech (understanding what is said to him) is affected. And the fact that he is echolalic means that he can use words and phrases that sound very grown up, but I know what TV programme or film they have come from.
Also the over emotional outbursts and reactions are typical. My son goes to foil fencing classes, and as part of the warm up exercises they use a skipping rope and have to run under it and then jump over it. He could run under, but not jump over. Neither could alot of the other children and coped with that fine. He was in tears in the floor every time! But he loves the sword fighting and is quite good at it (because he loves those films and copies the moves all the time).
Thank you for your response I found it to be most helpful. Yes he does have sensory issues--things like he will only wear particular colors, the temperature of the bath water must be the same each day, too many people and too loud of a place can cause problems. This last period of testing the Speech Therapist determined that there were no problems, but this is because I had him in a program earlier (which we had fairly recently completed) because of speech delays. He would have meltdowns because he couldn't communicated what he wanted and became frustrated. He will also copy what is said and movements from DVDs and television programs he will watch. The one thing this last group of individuals would consistently tell me is that if he doesn't do the spinning and he can make eye contact then he isn't autistic. Is this true? Do children on the autistic spectrum have what they referred to as "classic behavior" for autism?
Thank you for your suggestions and direction. I really appreciate your insight to this.
Thank you for your suggestions and direction. I really appreciate your insight to this.
I don't know about gifted children. I have an 8 year old son on the autistic spectrum, and the behaviours you mention sound similar.
What children/adults with autism do have is called a 'spiky profile', so they can do brilliantly at some things and very poorly at others. For example, on percentile testing my son scored 93% in some areas and 2% in others.
You say he has had alot of assessments done through the school. When the Speech Therapist assessed him I presume she tested his expressive and receptive speech as well as semantics/pragmatics, working memory, auditory memory/auditory processing etc, comprehension, inference etc - and that everything came back okay. The reason I ask is that educational assessments are not as thorough as health assessments, and private assessments are the most thorough of all. That is basically because everything runs on a budget and the more they find with your son the more support (and therefore monetary input) he will need. I think you need to know why he isn't responding to conversations and answers with unrelated answers (which is what my son did). I would ask him a question and he either answered appropriately, appeared deaf, or gave a totally unrelated answer like he wasn't interested in what I was saying.
Does your son repeat words or phrases from TV/DVDs or from other people? Does he re-enact stuff off the TV and do all the moves. You mentioned he has to do the moves, what did you mean?
My son also shows alot of frustration, tears, anger when things don't go to plan. So he may attempt to do something and he knows how it should turn out, but if he cannot do it perfectly he gets very upset, and it takes him a long time to recover.
Those on the spectrum also have very good days and very bad days. It isn't consistent because it is neurologically based. There also tends to be alot of sensory issues involved and their environments can just become too much for them and make them hyper or they shut down and retreat into themselves. Is he over or under sensitive with his vision, hearing, touch, taste, smell, balance and co-ordination? Sensory Integration Disorder fluctuates day to day and even throughout the day. So you will get different responses to the same stimulus.
My son has his 'typical' days, his 'fizzy days' his 'emotional' days. And I also think that he is remarkably intelligent, but he isn't able to really demonstrate that because he is still struggling to read and write. But he can memorise a book or DVD after the first reading. He comes out with statements like "humans cannot fly because of gravity".
And, if it is any reassurance, there are lots of parents in a similar position of just not knowing what is responsible for the things they are seeing.
What I would recommend is firstly keeping a diary of everything he does that concerns you or that he cannot do as well as the things he can do.
He is now 4, and his social side should be developing in line with his peers. I would recommend that you go to his paediatrician and ask them to refer you to a multi-disciplinary team that has experience of diagnosing autistic spectrum disorders including Aspergers. They should be much better at identifying which behaviours might be autistic/aspergers. Mention your other concerns to them about ADHD and Bi-polar as well as the possibility that he is gifted. His meltdowns might be down to being gifted (if that is typical of gifted children), or it might be down to rigid thinking where he expects something to happen in a certain way and when it doesn't then all hell breaks loose. Rigid thinking can affect how they respond to their own performance (ie. he dropped the ball), to other peoples performance (they didn't do it as he wanted/expected), to social interaction (they didn't play the game I wanted/didn't say the words/didn't do it right) etc. And if he does have autistic behaviours there will be times when everything goes to plan and he will be happy, and other days when you give him a different breakfast, he doesn't want those socks with those shoes, you go a different route to school, the teacher does something in a different way, the school dinner tastes different, etc etc and on those days he will not cope at all and will have meltdown after meltdown. That might give the impression of bi-polar, I don't know.
I think you need to get into a routine for behaviour. When he is having a meltdown (when at home), I tell my son "I can see you are very angry/sad/mad about XXXX, and you need to go to your bedroom to calm down." As he is 8 I would leave him for 8 minutes then check if he is calmer (usually you can hear if he is calmer!). Don't accept any hitting, kicking, punching etc. Tell him that is not acceptable behaviour. Try to use the bedroom as a calm down time out strategy and not as a punishment ie. don't say you have been naughty go to your bedroom. The idea is that they may need to use the same technique in school and therefore they need a 'quiet room' set aside that he can be taken to to calm down, and he mustn't get the feeling that he is being punished or sent to a prison like room.
Finally it is quite possible that he has more than one disorder or traits of several disorders, but not enough of any of them to get a full diagnosis. So you may have a highly intelligent child with traits of aspergers/ADHD etc. Sometimes you do need to wait and see how things develop. But that doesn't mean that he doesn't get any support or therapies until he has a full blown diagnosis.
In the meantime they will have to meet all his needs in school and I think you need some answers quite soon to help you decide what type of school is going to best suit him. An Educational Psychologist should be able to give you an indication of his cognitive ability and what type of schooling would best suit him. A Speech and Language Therapist should assess all his language skills (as mentioned above), as well as his social interaction/play skills.
What children/adults with autism do have is called a 'spiky profile', so they can do brilliantly at some things and very poorly at others. For example, on percentile testing my son scored 93% in some areas and 2% in others.
You say he has had alot of assessments done through the school. When the Speech Therapist assessed him I presume she tested his expressive and receptive speech as well as semantics/pragmatics, working memory, auditory memory/auditory processing etc, comprehension, inference etc - and that everything came back okay. The reason I ask is that educational assessments are not as thorough as health assessments, and private assessments are the most thorough of all. That is basically because everything runs on a budget and the more they find with your son the more support (and therefore monetary input) he will need. I think you need to know why he isn't responding to conversations and answers with unrelated answers (which is what my son did). I would ask him a question and he either answered appropriately, appeared deaf, or gave a totally unrelated answer like he wasn't interested in what I was saying.
Does your son repeat words or phrases from TV/DVDs or from other people? Does he re-enact stuff off the TV and do all the moves. You mentioned he has to do the moves, what did you mean?
My son also shows alot of frustration, tears, anger when things don't go to plan. So he may attempt to do something and he knows how it should turn out, but if he cannot do it perfectly he gets very upset, and it takes him a long time to recover.
Those on the spectrum also have very good days and very bad days. It isn't consistent because it is neurologically based. There also tends to be alot of sensory issues involved and their environments can just become too much for them and make them hyper or they shut down and retreat into themselves. Is he over or under sensitive with his vision, hearing, touch, taste, smell, balance and co-ordination? Sensory Integration Disorder fluctuates day to day and even throughout the day. So you will get different responses to the same stimulus.
My son has his 'typical' days, his 'fizzy days' his 'emotional' days. And I also think that he is remarkably intelligent, but he isn't able to really demonstrate that because he is still struggling to read and write. But he can memorise a book or DVD after the first reading. He comes out with statements like "humans cannot fly because of gravity".
And, if it is any reassurance, there are lots of parents in a similar position of just not knowing what is responsible for the things they are seeing.
What I would recommend is firstly keeping a diary of everything he does that concerns you or that he cannot do as well as the things he can do.
He is now 4, and his social side should be developing in line with his peers. I would recommend that you go to his paediatrician and ask them to refer you to a multi-disciplinary team that has experience of diagnosing autistic spectrum disorders including Aspergers. They should be much better at identifying which behaviours might be autistic/aspergers. Mention your other concerns to them about ADHD and Bi-polar as well as the possibility that he is gifted. His meltdowns might be down to being gifted (if that is typical of gifted children), or it might be down to rigid thinking where he expects something to happen in a certain way and when it doesn't then all hell breaks loose. Rigid thinking can affect how they respond to their own performance (ie. he dropped the ball), to other peoples performance (they didn't do it as he wanted/expected), to social interaction (they didn't play the game I wanted/didn't say the words/didn't do it right) etc. And if he does have autistic behaviours there will be times when everything goes to plan and he will be happy, and other days when you give him a different breakfast, he doesn't want those socks with those shoes, you go a different route to school, the teacher does something in a different way, the school dinner tastes different, etc etc and on those days he will not cope at all and will have meltdown after meltdown. That might give the impression of bi-polar, I don't know.
I think you need to get into a routine for behaviour. When he is having a meltdown (when at home), I tell my son "I can see you are very angry/sad/mad about XXXX, and you need to go to your bedroom to calm down." As he is 8 I would leave him for 8 minutes then check if he is calmer (usually you can hear if he is calmer!). Don't accept any hitting, kicking, punching etc. Tell him that is not acceptable behaviour. Try to use the bedroom as a calm down time out strategy and not as a punishment ie. don't say you have been naughty go to your bedroom. The idea is that they may need to use the same technique in school and therefore they need a 'quiet room' set aside that he can be taken to to calm down, and he mustn't get the feeling that he is being punished or sent to a prison like room.
Finally it is quite possible that he has more than one disorder or traits of several disorders, but not enough of any of them to get a full diagnosis. So you may have a highly intelligent child with traits of aspergers/ADHD etc. Sometimes you do need to wait and see how things develop. But that doesn't mean that he doesn't get any support or therapies until he has a full blown diagnosis.
In the meantime they will have to meet all his needs in school and I think you need some answers quite soon to help you decide what type of school is going to best suit him. An Educational Psychologist should be able to give you an indication of his cognitive ability and what type of schooling would best suit him. A Speech and Language Therapist should assess all his language skills (as mentioned above), as well as his social interaction/play skills.
I am so glad that you said that he was very intelligent, because that's it! Smart kids are so much harder to raise. I have a daughter who was advanced for her age and the entire first paragraph that you wrote could be her when she was your son's age. Their mind is so much more advanced than their body. They want to do so much more than they physically can. When they are babies, they cry all the time because they are bored and want to do things that they cannot do. This starts right after birth. The nurses at the hospital were so mad at my daughter because they had to fight with her to dress her and she was only 2 days old. Lots of energy with smart children. Try to find out if there is a seminar about raising very intelligent children. I went to one and it really helped me to be able to raise our daughter. She was quite the challenge the first 7 years of her life. She is now 11 and a very sweet nice girl (so they do change). I have no problems with her whatsoever now. My daughter would think differently at a very young age. She built a snowman outside at age 4 and put two faces on it, one facing my house and one facing my parents house so when each of us looked out the window they would see the snowman's face. Enroll him in the gifted and talented program so that he is challenged mentally. Raising smart children is not easy and it will be hard. The plus side is that you will be so impressed with him once he starts school and starts ranking up those great grades.
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